How can I
implement routine clinical outcomes measurement in my organisation or
service?

You will need

the
support of many (but not all) of your colleagues

to
agree the outcomes you wish to measure

to
identify the measure(s) you can use feasibly and with minimal
cost (e.g. license fees). You may choose to use PROMS or CROMs
or both (see below). (It may help to consider this
outcomes grid).

to
train staff in gathering the data- by their ratings and/or from
service users

these
data include measures of health repeated over time, data on
context (e.g. diagnosis) and data on interventions

to
have some system for gathering data so that it can be analysed

to
have someone with the time and skills to analyse the data

to
have a system of regular information feedback to staff first,
and managers second, in a form that they can relate to (e.g. graphical
rather than statistical)

and
a system that helps change practice so that change (preferably
improvement) in outcomes may happen

What are
PROMs?

PROMs
stand for Patient Reported Outcomes Measures. These are filled in
by service users themselves, rather than by staff- see the
outcomes grid. Measures given to them by staff but
completed by service users do not necessarily mean that the outcomes
being studied are those of greatest relevance to them. See this
wikipedia entry on the recovery model which does not
sit well with many systems of routine clinical outcomes measurement.

What are
PREMs?

PROMs
stand for Patient Reported Experience Measures. These are filled
in by service users themselves, but report their experience of the
services they receive, rather than the outcomes. So a service user
might have experience a warm, caring environment in an inpatient
unit but leave it no better than when they came in. Equally, they
may have a dreadful experience but leave the ward functioning much
better.

What are
CROMs?

CROMs
stand for Clinician Rated Outcomes Measures. These are completed
by clinicians, who use their judgment to rate how well the service
user is at various points during their contact with sercvices. The
Health of the Nation Outcomes Scales (HoNOS) constitute a CROM.